Provider Demographics
NPI:1710120837
Name:PREDMORE, PAMELA FRANCES (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:FRANCES
Last Name:PREDMORE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17219 MILLSTONE CT
Mailing Address - Street 2:
Mailing Address - City:MARENGO
Mailing Address - State:IL
Mailing Address - Zip Code:60152-8129
Mailing Address - Country:US
Mailing Address - Phone:815-923-4743
Mailing Address - Fax:
Practice Address - Street 1:ECKER CENTER
Practice Address - Street 2:1845 GRANDSTAND
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120
Practice Address - Country:US
Practice Address - Phone:847-429-8786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1800003657101YP2500X
IL180-003657101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool